Semaglutide: Breakthrough drug for weight loss & sugar control

By Dr Utkarsh Shah
Critical Care Specialist

India is seeing a major shift in treating obesity and type 2 diabetes with once-weekly semaglutide. It mimics the GLP-1 hormone to reduce appetite, slow digestion, and improve insulin release, leading to better blood sugar control and significant weight loss. In India, where diabetes and obesity are rising rapidly, clinical trials (STEP and SUSTAIN) show 12–15% weight loss, improved HbA1c, and possible heart benefits, making it a powerful dual-action therapy.

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Who can benefit

Semaglutide is useful in:

1. Type 2 diabetes patients with poor glycaemic control
2. Overweight or obese individuals (BMI ≥27 with comorbidities or ≥30)
3. Patients with cardiovascular risk factors
4. Individuals struggling with lifestyle-only weight loss

However, it is not a cosmetic "weight-loss injection" and must be used under medical supervision.

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Side effects to watch for

While generally well tolerated, certain side effects need attention:

1. Gastrointestinal: Nausea, vomiting, early satiety, constipation
2. Rare but important: Pancreatitis, gallstones
3. Others: Dehydration (especially in elderly), worsening diabetic retinopathy (in rapid glucose lowering)

A gradual dose escalation helps minimise intolerance. Patients should be educated to report persistent abdominal pain or severe vomiting.

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How to make most of it

Semaglutide is not a magic bullet. Its success depends on integration with lifestyle changes:

1. Diet: High-protein, fibre-rich Indian diets; portion control
2. Exercise: At least 150 minutes/week of moderate activity
3. Sleep & stress: Often overlooked but crucial
4. HbA1c, renal function

Importantly, stopping the drug without lifestyle correction often leads to weight regain.

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Road ahead:

Semaglutide represents a major step forward in metabolic medicine. With proper patient selection, education, and monitoring, it has the potential to reduce the burden of diabetes, obesity, and cardiovascular disease in India. However, the key message remains clear: medication can support the journey, but sustainable health still depends on lifestyle.

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Published in Lokmat Times, Nagpur Main, Page No. 7, May 07, 2026